• 대한임상독성학회지
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• 제9권2호
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• pp.39-48
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• 2011

In mass casualty situation due to radiological accidents, it is important to start aggressive management with rapid triage decisions. External contamination needs immediate decontamination and internal contamination should be treated with special expertise and equipment to prevent the rapid uptake of radionuclides by target organs. Acute radiation syndrome shows a sequence of events that varies with the severity of the exposure. More severe exposures generally lead to more rapid onset of symptoms and severe clinical findings. After the massive exposure, various systems of the body reflect their severe damages that can lead to death within hours or up to several months. The disease progression has classically been divided into four stages: prodromal, latent, manifest illness, and recovery or death. Three characteristic clusters of symptoms including the hematopoietic syndrome, the gastrointestinal syndrome and the cerebrovascular syndrome are all associated with the acute radiation syndrome. The standard medical management of the patients with a potentially survivable radiation exposure includes good medical, surgical and supportive measures. Specific treatment with cytokines and bone marrow transplantation should be considered. The management of internal contamination is much the same as the treatment of poisoning. The standard decontamination should be applied to reduce uptake, and the chelating agents can be administered to enhance the clearance of radioisotopes. Radioactive iodine ($^{131}I$) as one of the nuclear fission products can increase the incidence of thyroid cancer in children. Potential benefit of potassium iodide prophylaxis is greater especially in neonates, infants and small children.

• 대한임상독성학회지
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• 제1권1호
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• pp.47-50
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• 2003

Endosulfan, one of organochlorine insecticides, is $\gamma$-aminobutyric acid (GABA) antagonist. In sufficient dose, this pesticide lower the seizure threshold and produce CNS stimulation, with resultant seizures, respiratory failure, and death. In patients with endosulfan intoxication, the first manifestation of toxicity is largely a generalized seizure without prodromal signs or symptoms. So the management of airway and seizure control are essential for survival and prognosis of intoxicated patients. We report two cases of acute endosulfan poisoning who manifest 'status epilepticus' similarly, but have different prognosis.

• Journal of Chest Surgery
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• 제22권6호
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• pp.1049-1055
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• 1989

We have reviewed 73 patients who experienced hemoptysis with pulmonary tuberculosis to analyze the factors contributing hemoptysis and its management The result are; 1. The age group between 30 * 50 years old was major prevalent group [59%]. 2. Sexual ratio was 3.9 to 1, as 58 men and 15 women. 3. In 58 patients [79.5 %], the number of hemoptysis in frequency was less than 5 times. 4. The quantity of hemoptysis was ranged from less than 50 ml to more than 600 ml and 20 patients [27.4%] experienced bleeding more than 600 ml at once. 5. There was no seasonal difference in hemoptysis. 6. The common prodromal symptoms of hemoptysis were coughing, fatigability, hot foreign sensation of throat in order of frequency. 7. In chest roentgenographic finding, the cavitary lesion was the most common finding, 67% [51 cases], and the multiple cavity was 19.2%[14 cases]. 8. 23 patients [31.37%] were operated for control of hemoptysis and pulmonary tuberculosis itself, 7[30.43 %] of them suffered from complication of empyema, respiratory failure, empyema with bronchopulmonary fistula. 9. One patient [4%] was died due to respiratory failure after left thoracoplasty.

• Journal of Korean Dental Science
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• 제7권2호
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• pp.99-105
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• 2014

Herpes zoster (HZ) is an acute, unilateral inflammatory viral infection characterized by a rash with painful blisters in a localized area of the body. HZ is often associated with intense pain in the acute phase and presents postherpetic neuralgia in the chronic phase. During the prodromal stage of the HZ from the trigeminal nerve, however, the only presenting symptom may be odontalgia, which could be particularly difficult to diagnose. This distinctive syndrome occurs predominantly in the immunocompromised or elderly individuals. In this article, we report a case of HZ developed in the trigeminal nerve of a 60-year-old immunocompromised female patient, whose symptoms including atypical, non-odontogenic odontalgia had improved after series of antiviral treatments.

• 의학교육논단
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• 제20권2호
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• pp.112-117
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• 2018

Attending the operation room is an essential part of surgical clerkships. Syncope or presyncopal attacks in the operation room may negatively affect students' learning and career development. This study set out to identify the prevalence of syncope and presyncopal attacks in the operation room during medical students' surgical clerkships. Data from 420 medical students (303 men and 117 women) in their 3rd year of clerkship were collected between 2014 and 2017. An anonymous questionnaire was distributed to assess the prevalence and degree of syncope and presyncopal symptoms. A total of 27% of the respondents had experienced syncope or presyncopal symptoms, 49.6% of the female students and 18.8% of the male students (p<0.001). Fifty students (43.5%) had been attending as observers at the time of the syncopal attack, while 65 students (56.5%) had been participating as assistants. Thirty-four students (29.6%) had recently eaten at the time of the syncopal attack, while 81 students (70.4%) had not recently eaten. Prodromal symptoms included the urge to sit down (21.2%), sweating (19.3%), nausea (16.9%), a feeling of warmth (13.3%), darkened vision (12.6%), yawning (11.7%), palpitation (11.0%), ear fullness (10.2%), black spots in one's vision (7.6%), and hyperventilation (7.1%). This study showed the prevalence of syncope and presyncopal symptoms in the operation room during surgical clerkships. For students' safety and effective clerkship learning, thorough proactive education on syncopal attacks is required.

• 생물정신의학
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• 제18권4호
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• pp.210-216
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• 2011

Subsyndromal depression (SSD) is found to be more prevalent than major depressive disorder (MDD) and minor depressive disorder (MnDD). SSD is also associated with adverse clinical outcomes, increased risk of suicide, increased social dysfunction and disability, increased risk for future mood disorders, and increased uses of medical and mental health services. DSM-IV diagnostic criteria are not suitable for capturing SSD. Although there is no agreement on gold standard to define SSD so far, three definitions of SSD are available. First, SSD is defined as having two or more current depressive symptoms without core depressive symptoms (depressive mood or loss of interest) and with time threshold (most of the day and nearly every day over at least two weeks). Second, SSD is defined as having two or more current depressive symptoms with core depressive symptoms and without time threshold. Third, SSD is defined by using cutoff points of depression rating scales. SSD may represent a prodromal, residual, or interepisode symptomatic state in the course of MDD and MnDD. More than a half of SSD patients became any type of depressive disorders (SSD, MnDD and MDD) at 1 year. SSD may represent a discrete category of its own, without prior or consequent episodes of MDD. Considering clinical significance of SSD such as its high prevalence, significant psychosocial impairment and chronicity and serious outcomes, researchers and clinicians should be more vigilant in capturing and caring for patients with SSD.

• Pediatric Infection and Vaccine
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• 제2권2호
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• pp.200-206
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• 1995

Myocarditis refers to inflammation, necrosis, or myocytolysis that may be due to many infectious, connective tissue and many other causes affecting the myocardium or involvement of the endocardium or pericardium. The most common manifestation is congestive heart failure, although arrhythmias and sudden death may be the first sign of myocarditis. Viral myocarditis is typically a sporadic but occasionally epidemic illness, noted as an acute potentially fulminant disease of 1-to 4-wk-old infants, as an acute but more benign myopericarditis of toddlers and young children. The most common casuative agent in viral myocarditis is Coxsackievirus and the outcome of the biopsy-proven chronic dilated cardiomyopathy associated with Coxsackievirus is poor without therapy. Myocarditis may be confirmed by percutaneous endomyocardial biopsy and the viral myocarditis may be diagnosed by the serological viral study with the clinical manifestations. He was admitted for the management of tachyarrhythmias occurred suddenly without prodromal symptoms and signs and diagnosed as viral pancarditis by serological Coxsackievirus study, echocardiogram, chest x-ray, EKG and other clinical manifestations.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권2호
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• pp.219-230
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• 2005

목적 : 소아, 청소년기 발병 정신분열병은 성인기 발병 정신분열병보다 전구증상을 동반하여 점진적으로 발생하고 심각한 인지기능저하와 신경해부학적 결손을 보여주는 예후가 안좋은 질환으로 알려져왔다. 금번 연구의 목적은 13세를 기준으로 소아, 청소년기 발병 정신분열병을 두 그룹으로 나누어 인구학적 자료, 임상적 특징, 발달학적 지연, 심리학적 특성을 비교하여 소아-청소년기 발병 정신분열병에 대한 이해를 높이고자 하였다. 방법 : 17명의 소아기발병 정신분열병(매우이른 발병) 입원 환아와 16명의 청소년기발병 정신분열병(이른 발병) 입원 환아의 의무기록을 조사하였다. 두 그룹의 기록에서 성별, 연령, 정신과적 과거력, 전구증상 및 기간, 아형, 공존질환, 발달력상 지연, 처방약물 및 용량, 치료반응, 지능지수와 로샤검사를 평가하였다. 결과 : 소아기발병(매우 이른발병)과 청소년기 발병(이른 발병) 정신분열병의 평균 입원 연령은 12.69세$({\pm}2.34)$와 15.13세$({\pm}1.04)$였다. 소아기발병(매우 이른발병)과 청소년기 발병(이른 발병) 정신분열병의 평균 발병 연령은 10.79세 $({\pm}1.95)$와 14.46$({\pm}0.82)$세 였다. 소아기발병 (매우 이른발병)과 청소년기 발병 (이른 발병)의 평균 전구기간은 15.94개월$({\pm}12.33)$과 8.06$({\pm}6.10)$ 개월이었다. 소아기발병 (매우 이른 발병)과 청소년기 발병 (이른 발병)의 관해에까지 이르는데 걸리는 시간은 50.58$({\pm}24.67)$일과 30.06(18.04) 일이었다. 소아기발병 (매우 이른 발병) 그룹에서 관해에까지 이르는 기간이 길수록 일찍 발병 하였다. 두 그룹에서 전체지능, 언어성지능, 동작성 지능은 평균수준이었다. 결론 : 소아기발병(매우 이른 발병)과 청소년기 발병(이른 발병) 정신분열병은 이전의 연구결과와 마찬가지로 전구증상과 함께 전구기간이 존재하고 발달력상 지연이 있을 수 있으며 입원 당시 명백한 정신병적 증상이 존재한다는 점에서는 비슷하지만 청소년기 발병(이른 발병) 그룹에 비해 소아기발병(매우 이른발병) 그룹은 전구기간이 더 짧았으며 발병연령이 늦을수록 관해에 이르는 기간이 짧은 것으로 나타났다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권3호
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• pp.268-272
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• 2007

Herpes zoster is caused when the varicella zoster virus(VZV) that has remained latent since an earlier varicella infection is reactivated with cutaneous and mucous manifestations. They occur in 20% cases in the trigeminal area and typical manifestations are neuralgias simulating dental pain, also vesicles with an erythematous halo located in the territory of the second and third trigemial branch. They erupt on the skin, the lips, tongue, palate and cheeks. With an ever-increasing number of elderly and immunocompromised patients attending the dentist, the dental profession can expect to encounter an increased number of herpes zoster patients. Furthermore, the oral and maxillofacial surgeons must be familiar with the presenting signs and symptoms of patients experiencing the prodromal manifestations and oral complication of herpes zoster of the trigeminal nerve. As presentation of our patient with ulcer on hard palate caused by herpes zoster, current treatment of herpes zoster and post-herpetic neuralgia are discussed.

• 대한한방내과학회지
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• 제42권5호
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• pp.1082-1093
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• 2021

Objective: Alzheimer's disease is characterized by progressive, irreversible brain damage and cognitive decline. Although the diagnosis and treatment of the prodromal symptoms of dementia are important, no treatment for mild cognitive impairment has been currently established. Herein, we report the case of an 80-year-old female patient with memory complaints treated with Gugijihwang-tang, a traditional Korean medicine herbal formula, as an add-on medication. Case Presentation: The patient was diagnosed with mild cognitive impairment based on clinical examinations using the Mini-Mental State Examination (MMSE), the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Activities of Daily Living (ADL) Scale, Global Deterioration (GDR) Scale, and Clinical Dementia Rating (CDR) Scale. She was treated with Gugijihwang-tang bis in die for 12 months while continuing her original medications, including 5-mg donepezil and 590-mg acetyl-l-carnitine. The MMSE score in the Korean Version of the CERAD Assessment Packet increased from 21 to 27 during the 12-month treatment period, and the CERAD 2 score increased from 33 to 62. The instrumental ADL scale score improved from 11 to 5. Other clinical examination results also showed improvement. The patient was satisfied and experienced no significant adverse events related to the Gugijihwang-tang treatment. Conclusion: This case suggests that Gugijihwang-tang could be considered as a treatment method for patients with mild cognitive impairment.